̽��ֱ�� of Cambridge - Mark Kotter

Cambridge researchers launch charity to tackle ‘slow motion spinal cord injury’ affecting up to a million UK adults

cjb250 — Mon, 06 May 2019 23:13:22 +0000

Myelopathy is caused by arthritic changes affecting the spinal column of the neck. Because of the close proximity, these can exert pressure on the spinal cord and trigger a "slow motion spinal cord injury".

“If you haven’t heard of myelopathy, you are probably in good company,” said Dr Kotter. “Myelopathy is likely the most under-diagnosed neurological condition, yet it affects as many as a million adults in the UK.”

̽��ֱ��onset of myelopathy is often subtle: symptoms include numb and clumsy hands, imbalance, and urinary problems. When left unattended, it can progress with patients losing control of their hands and bladder, and becoming unable to walk. Myelopathy is now recognised as having one of the worst impacts on quality of life.

̽��ֱ��actual number of patients who suffer from this condition remain unclear. Recent research by Dr Kotter's team who analysed existing spinal MRI studies, indicates that as many as one in 50 adults may be affected.

Treatment options for myelopathy are limited. ̽��ֱ��only form of treatment that is effective consists of surgical decompression of the spinal cord. Despite this single option, the management of myelopathy patients remains highly divergent across the globe.

To raise awareness of myelopathy and to address gaps in our knowledge of the condition and how best to treat it, Dr Kotter and colleague Ben Davies, together with Iwan Sadler, a myelopathy-sufferer, have launched Myelopathy.org, a charity that aims to give patients a voice and effect change.

̽��ֱ��charity has grown out of an information website created by Dr Kotter and Mr Davies. Today, Myelopathy.org celebrates its official launch as the first charity dedicated to the condition at an event in the House of Lords hosted by Lord and Lady Carter of Coles. ̽��ֱ��launch will gather together top representatives from the NHS, politics, research councils, charities, and health care providers.

“Today’s event shows how research can impact not only academia and industry, but inspire grassroots initiatives that bring together individuals in order to tackle important issues,” said Dr Kotter. “It is also a clear demonstration of the difference that the ̽��ֱ�� of Cambridge can make to the lives of millions of patients worldwide.”

Previously, Dr Kotter and colleagues from the Spinal Cord Injury Knowledge Forum in the AOSpine, the world-largest spine surgeon network, brought together patients, health professionals including physicians, surgeons, physiotherapists, allied health professionals, and researchers to develop the first clinical guidelines for the treatment of myelopathy. ̽��ֱ��guidelines recommend monitoring the condition at early stages, but for moderate or severe forms, as well as any signs of deterioration, considering urgent surgical attention.

̽��ֱ��guidelines have been welcome by health care professional and sufferers around the globe, recognised by multiple national and international bodies, and are being implemented on a world-wide scale. As the guidelines also determine in which cases surgery is not appropriate, they are expected to benefit not only those that require treatment but also protect individuals from unnecessary surgery. This is a prime example of how research can translate rapidly and have positive impact on a global scale.

In the largest ever survey of myelopathy patients world-wide, carried out on the Myelopathy.org website, Dr Kotter's team asked sufferers questions, including: how long have they suffered from myelopathy? How long did it take to be diagnosed? Did they undergo surgery? At what stage is their disease? And, how does it affect their quality of life? Would they be interested in participating in research? And what would be their number one research priority?

“ ̽��ֱ��results of our survey were shocking: on average it takes more than two and a half years to be diagnosed,” said Mr Davies. “As many as a third of patients have to wait more than five years. These delays can result in increased disability and suffering on an individual level, and most likely also to heavy financial burden on health care systems.

“We need to look at why the condition is not recognised earlier and how this situation can be changed. Are there gaps in knowledge amongst health professionals, or in the health care system?”

̽��ֱ��bulk of clinical research so far has been conducted on surgical approaches to myelopathy, but this research did not provide any firm conclusions. One of the reasons is that the primary outcomes of studies in myelopathy vary considerably. This renders studies difficult to compare.

In addition, researchers often fail to take into account the patient perspective. For example, patients responded to the survey that pain is their number one priority; however, only a fraction of studies measure pain and very few have asked how this can be addressed.

As well as celebrating the launch of Myelopathy.org, today's event also announces RECEDE (REgeneration in CErvical DEgenerative) Myelopathy, the first regenerative medicine trial for the condition. ̽��ֱ��clinical trial is sponsored by the National Institute for Health Research and is being carried out as a joint UK-collaboration. It is expected to begin later this year.

Today sees the official launch of Myelopathy.org, a charity dedicated to one of the most common, yet under-diagnosed neurological conditions. ̽��ֱ��charity is the brainchild of Dr Mark Kotter, neurosurgeon and clinician scientist at the ̽��ֱ�� of Cambridge, who works on a disorder known officially as Degenerative Cervical Myelopathy.

If you haven’t heard of myelopathy, you are probably in good company. Myelopathy is likely the most under-diagnosed neurological condition, yet it affects as many as a million adults in the UK.

Mark Kotter

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“With this vial, we could potentially feed the entire planet”

cjb250 — Thu, 08 Nov 2018 11:17:47 +0000

New stem cell method produces millions of human brain and muscle cells in days

cjb250 — Thu, 23 Mar 2017 16:50:39 +0000

Human pluripotent stem cells are ‘master cells’ that have the ability to develop into almost any type of tissue, including brain cells. They hold huge potential for studying human development and the impact of diseases, including cancer, Alzheimer’s, multiple sclerosis, and heart disease.

In a human, it takes nine to twelve months for a single brain cell to develop fully. It can take between three and 20 weeks using current methods to create human brain cells, including grey matter (neurons) and white matter (oligodendrocytes) from an induced pluripotent stem cell – that is, a stem cell generated by reprogramming a skin cell to its ‘master’ stage. However, these methods are complex and time-consuming, often producing a mixed population of cells.

̽��ֱ��new platform technology, OPTi-OX, optimises the way of switching on genes in human stem cells. Scientists applied OPTi-OX to the production of millions of nearly identical cells in a matter of days. In addition to the neurons, oligodendrocytes, and muscle cells the scientists created in the study, OPTi-OX holds the possibility of generating any cell type at unprecedented purities, in this short timeframe.

To produce the neurons, oligodendrocytes, and muscle cells, the team altered the DNA in the stem cells. By switching on carefully selected genes, they reprogrammed the stem cells and created a large and nearly pure population of identical cells. ̽��ֱ��ability to produce as many cells as desired combined with the speed of the development gives an advantage over other methods. ̽��ֱ��new method opens the door to drug discovery, and potentially therapeutic applications in which large amounts of cells are needed.

Study author Professor Ludovic Vallier from the Wellcome Trust-Medical Research Centre Stem Cell Institute at the ̽��ֱ�� of Cambridge says: “What is really exciting is we only needed to change a few ingredients – transcription factors – to produce the exact cells we wanted in less than a week. We over-expressed factors that make stem cells directly convert into the desired cells, thereby bypassing development and shortening the process to just a few days.”

OPTi-OX has applications in various projects, including the possibility to generate new cell types which may be uncovered by the Human Cell Atlas. ̽��ֱ��ability to produce human cells so quickly means the new method will facilitate more research.

Joint first author, Daniel Ortmann from the ̽��ֱ�� of Cambridge, adds: “When we receive a wealth of new information on the discovery of new cells from large scale projects, like the Human Cell Atlas, it means we’ll be able to apply this method to produce any cell type in the body, but in a dish.”

Dr Mark Kotter, lead author and clinician, also from Cambridge, says: “Neurons produced in this study are already being used to understand brain development and function. This method opens the doors to producing all sorts of hard-to-access cells and tissues so we can better our understanding of diseases and the response of these tissues to newly developed therapeutics.”

̽��ֱ��research was supported by Wellcome, the Medical Research Council, the German Research Foundation, the British Heart Foundation, ̽��ֱ��National Institute for Health Research UK and the Qatar Foundation.

Reference
Matthias Pawlowski et al. Inducible and deterministic forward programming of human pluripotent stem cells. Stem Cell Reports; 23 Mar 2017; DOI: 10.1016/j.stemcr.2017.02.016

Adapted from a press release by the Wellcome Trust Sanger Institute.

Scientists at the ̽��ֱ�� of Cambridge and the Wellcome Trust Sanger Institute have created a new technique that simplifies the production of human brain and muscle cells - allowing millions of functional cells to be generated in just a few days. ̽��ֱ��results published today in Stem Cell Reports open the door to producing a diversity of new cell types that could not be made before in order to study disease.

This method opens the doors to producing all sorts of hard-to-access cells and tissues so we can better our understanding of diseases and the response of these tissues to newly developed therapeutics

Mark Kotter

Sanger Institute - Grow Muscle and Brain in a dish: OPTi-OX in action

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